Radiation Dose-Volume Effects in the Brain

Journal Article · Mon Mar 01 00:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.02.091· OSTI ID:21372126

Li, X Allen ^[1]; El Naqa, Issam ^[2]; Hahn, Carol A ^[3]; Marks, Lawrence B ^[4]; Merchant, Thomas E ^[5]; Dicker, Adam P ^[6]

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1. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)
2. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States)
3. Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)
4. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (United States)
5. Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States)
6. Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (United States)

We have reviewed the published data regarding radiotherapy (RT)-induced brain injury. Radiation necrosis appears a median of 1-2 years after RT; however, cognitive decline develops over many years. The incidence and severity is dose and volume dependent and can also be increased by chemotherapy, age, diabetes, and spatial factors. For fractionated RT with a fraction size of <2.5 Gy, an incidence of radiation necrosis of 5% and 10% is predicted to occur at a biologically effective dose of 120 Gy (range, 100-140) and 150 Gy (range, 140-170), respectively. For twice-daily fractionation, a steep increase in toxicity appears to occur when the biologically effective dose is >80 Gy. For large fraction sizes (>=2.5 Gy), the incidence and severity of toxicity is unpredictable. For single fraction radiosurgery, a clear correlation has been demonstrated between the target size and the risk of adverse events. Substantial variation among different centers' reported outcomes have prevented us from making toxicity-risk predictions. Cognitive dysfunction in children is largely seen for whole brain doses of >=18 Gy. No substantial evidence has shown that RT induces irreversible cognitive decline in adults within 4 years of RT.

• OSTI ID: 21372126
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 76, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2009.02.091; PII: S0360-3016(09)03287-8; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
CHILDREN
FRACTIONATED IRRADIATION
NECROSIS
RADIATION DOSES
RADIOTHERAPY
SURGERY
TOXICITY
AGE GROUPS
ANIMALS
BODY
CENTRAL NERVOUS SYSTEM
DOSES
IRRADIATION
MAMMALS
MAN
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PRIMATES
RADIOLOGY
THERAPY
VERTEBRATES